Holden D. Mangum (Feb 1, 2009)

As recorded by Sabrena Suite-Mangum



THE BACKGROUND
Many a time I have discussed my desire for a natural childbirth. Danny and I studied the hypnobirthing method; believing that it was the best fit for us (again, no judgments on anyone else’s birthplan.) I just always felt convicted I would have an epidural-free natural birth (at least once). I had even desired to birth at home, though my husband, his parents and my parents were not so game. I imagined my birthing experience as a meditative surrender allowing my baby to join this world when he was ready; and I had released any and all fear regarding the next stage of my life… But the Lord (and Holden) apparently had a different plan.

DUE DATE APPROACHING…AND PASSED
Two days prior to my due date, my exam revealed that I had not dilated…AT ALL. And though they were willing to let me go a week over (because at the time the non-stress test reveled that everything looked copasetic with Holden) each night that week, as we were on countdown to being induced, I would go to bed hopeful… yet anxious that “tonight would be the night.” Every Braxton-Hicks contraction that would come, I would say a silent prayer hoping that my body would launch into a 20 minute pattern… starting the process and saving me from pitocin on Sunday… continually hopeful tonight would be the night I’d wake Danny, hand on his shoulder nudging him and saying the blessed words: “It’s time.” But every morning I would wake up – still in my bed -- a little bit sadder and little bit heart broken fearful that I was in fact broken. What was the hold up?

I knew that the universe was trying to teach me something: Patience? Acceptance? Letting go of my will?… There was a reason that Holden was not yet with us; that I understood, but I wasn’t sure what that reason was.

But as a firm believer in the old adage that “God helps those who help themselves,” we tried the pregnancy pizza at Trio, walking, jogging, sex, raspberry leaf tea, acupressure, spicy food, energy work, blessings and of course… a lot of prayer. Everything short of caster oil, and yet still Holden did not come.

SATURDAY IS A SPECIAL DAY
And so the 31st came. I was to call the hospital at 4pm that afternoon to find out what time they wanted me there to start the cervidil. (And I’ve shared some details on how that went…) I started Saturday morning with 75 minutes of Yoga at Flow – I told my guru I was going to try and “twist the baby out.” Danny and I had our last supper of sorts at Pinion since I couldn’t eat anything after 12-noon that day. (Which is one more thing that made me nervous because my hypno teacher told our class one of the #1 reasons women don’t succeed at “natural” is because of fatigue from not eating… “So stay home as long as possible” she and my midwife counseled. But obviously that part of the birth plan had changed from necessity as well.)

Danny and I spent the rest of the afternoon together … every so often I’d get a little emotional (ok, totally break down in tears); but I felt strangely calm despite things going completely opposite of how I saw them a week prior.

My friend, guru, massage therapist, yoga instructor and cranial-sacral magic worker came over to do some more work and invite Holden to join us in the world. (That sounds like a lot of people, but really it’s just one… Jami Larsen, and she does great work and has been such a blessing throughout my pregnancy.) As I mentioned, Danny had also given me a couple of blessings – one Friday night that was amazing.

One thing I noticed, looking back though, is how in tune my husband is. Many times I have heard him pray for specifics as far as miracles he wants to see happen (a tumor on my nephew brain to shrink – go away, heal… it did. The cleft palate of his cousin’s daughter to be healed – it was. And so on and so forth.) I kept thinking he should just bless me that my cervix would dilate and everything would go the way we wanted (or something to that affect)… NO DICE.

I think on a spiritually conscious level, he knew that it wasn’t meant to be that way (so instead of trying to change God’s will, he tried to put my fears at ease)… and instead blessed me with patience, with understanding, with the ability to make good choices in the best interest of me and the baby… and he blessed the medical personnel that they would make good decisions… I had no idea what we were up against. But yet, reflecting back… I guess I did know; I just didn’t want to believe it...because “I was not the type of person who would need that type of medical intervention”… or so I wanted to believe.

Before we left for the hospital, I did my hair (I’m so vein. I wanted to have a cute picture of Holden and I one he was born. Instead….well, I couldn’t bring myself to post it on line I look so torn up.)

Both of our families stopped by be fore we left for St. Marks. I’ll never forget being in the back bedroom with my mom as we embraced, and I just wept. She knew I was disappointed that it was happening this way, but I really didn’t want Danny to see me upset one more time (oh if I had only known how many more opportunities their would be!)

And we made it to the hospital. (Again, details here. )

That night we slept not so soundly. Danny had one of those crappy birthpartner chairs that is not really a recliner, and his body was is way too long to be comfortable. My midwife had ordered a sleeping pill and STRONGLY suggested I indulge. Pretty ridiculous to be taking an ambien the night before delivery when I had had ONE Tylenol in 10 months… but c’est la vie, eh? I figured ½ a pill was a good compromise for both of us. (She seems to think I have control issues and some level of anxiety… where did she ever get that idea?!?!!? ;)

THE BIG DAY
The next morning we rose early; I did my makeup (again, at 10 months preggers and carrying 20-plus lbs of water weight alone, I needed all the help I could get.)

Kat (my midwife) arrived just after 9 and my exam revealed that after 12 hours of cervadil, I had dilated to a .5… yes you read that correctly, NOT a “5” but half a centimer. She let me take a bath (huzzah, I got to use the birthing tub afterall!) and I did my face, again… (which constituted more make-up application in an hour period than I usually have in a week.)

So we continued with the plan B, and they started the pitocin. I was all hooked up to IVs, an external fetal monitor and a blood pressure cuff -- so getting to the ladies required unhooking a bunch of plugs and chords and wheeling that stupid IV bag across the room… again, NOT how I pictured things going down. Not to mention I think my ace kept hanging out of that stupid hospital gown. Danny said he would live in one of those things if possible – he and I are so different.

The rest of the morning had nurses coming and going. They would move up the pitocin every 20 – 30 minutes or so and I would feel contractions sporadically but nothing to really write home about.

“Laura” (the nurse) joined us on a shift change and she was another tender mercy. She was real sweet about reading my birth plan and even apologized for using the word contraction (to which I told her I didn’t really have a problem with, although hypnobirthing lingo is to call them “surges” or “waves”)… by this time I was pleading “PLEASE BRING ON THE CONTRACTIONS!” We needed some sort of action below the belt line (or at it?)…

The monitors were not a real fair showcase of what I felt was happening… they’d show a really intense peak (and I would hardly feel it), and then another time I feel a tremendous surge and it would barely register. At the same time, it was hard to tell what was going on with Holden’s heart rate… there were signs that his heart rate was dropping with my contractions, but again… they couldn’t get a really sound reading; and since I hadn’t dilated, they couldn’t get internal monitors hooked up to tell.

After a while they made the decision to put me on oxygen because even without a real clear reading, it seemed pretty obvious that Holden was being stressed. And with one more intervention, I broke a little more… I was lying in a hospital bed (and everything about me screamed patient (no, not “patience” but a medical patient). The O2 was so loud, I couldn’t really hear what was being said – but Kat and the nurse often talked in hushed tones anyway.

I tried to stay the course with my relaxation, because the contractions were finding more of a groove at this point… and I was definitely starting to feel them. So I listened to a couple of the hypno scripts to take me into a deeper relaxed state and try to not be too upset. I was crying under my breath with the O2 mask on; and Danny just held my hand in a way that said, “I know this is hard for you, I know that you’re upset… but it’s going to be ok.”

Obviously I was worried about Holden at this point too…no mother wants to hear that there baby is in distressed. But the O2 seemed to help him and his heart rate appeared to be improving.

Around 2:30 or so, with the contractions more timely my mucous plug released which appeared to be a sign of progress. Kat decided on another cervical exam for a few reasons:
-perhaps I would be dilated enough to break my water and if there was room, she could get the internal fetal monitor on Holden so we’d have a better idea of what was going on with him (and we could also get a better reading of my contractions… since they still were not registering with how I was feeling them)

The exam revealed (after what now tallied 18 hours of induction/intervention) I was now at a 1.5. (Let’s all sigh heavily…) That was the bad news… but the good news was it gave Kat enough room to break my water and get the monitors inside.

As most will tell you having experience L&D, the contractions intensified after she broke my water… (and the whole “water breaking” thing is a tremendously disgusting feeling.) I kept telling Danny “Don’t look down! Don’t look down!”

DAZED AND CONFUSED
I have to admit that the next 2-3 hours are somewhat of a blur. Danny, my mom and apparently all the medical staff involved could see that with each contraction’s peak, Holden’s heart rate tanked. Kat could also see from breaking my water that Holden had had a bowel movement and as such there was meconium in the amniotic fluid meaning there was a risk of Holden aspirating.

Conversations continued on the side (I tried to stay in my state of hypnosis… which I think was easier to do with the oxygen on because it made it really difficult to hear anything… plus I had my iPod in and was listening to more birth scripts). At some point after watching the monitors for a bit Danny asked my mom “How much longer are we going to wait?” Again, I was pretty oblivious to anything going on. The contractions were steady and intense at about a minute and ½ to two minutes apart… but still, no dilation progress.

I kept breathing, working through the pain (yes, it was painful… but tolerable)… I felt really dazed and began to wonder how much longer I could go on for… apparently, the top dosage for the pitocin drip is 20… and I was hovering around an 18 – 19… again, recalling this period everything seems blurry (and I wasn’t even on meds!)

Sometime around 5 pm, Dr. Nelsen (the on-call OB that Kat practices under) showed up in my room, and I knew. . .He was here to deliver the news… the reality of what we were up against:

• Possibility of Holden aspirating
• That I was ONLY dilated to a 1.5 (after having my water broke and pitocin nearly maxed)
• We were looking at more than 20 hours since the induction process had started and hadn’t seen much progress
• My baby was in distress and we could continue to wait things out, but there was no guarantee I would ever dilate for Holden to get through the birth canal

He said it would be a different scenario if I was, say, at a 6 or a 7… but there was some reason we weren’t seeing progress:
• Maybe Holden was a bigger baby than the ultrasound showed
• The chord may have been wrapped around his neck

And I don’t remember how, but he presented the case for a cesarean. To which I turned to Danny and said:

“What do you think?”

And my husband, in his infinite wisdom responded: “Let’s go get our son.”

“I know right?” I responded, with tears streaming down the sides of my cheeks and into the oxygen mask.

At that point, I think everyone was breathing a sigh of relief. I think Kat was apprehensive… wondering if I would fight her on the decision…but our objective for the birth experience was the same the whole time – have a healthy baby (and a safe mommy)... we though hypno was our best bet for accomplishing that objective and that’s why we chose it. But the universe had something else in mind – though our objective could still be met.




They asked if I wanted something for the pain until surgery… but I was still committed to not having meds for the contractions so I declined… instead, Danny gave me a back rub which was helpful… but then somewhere between turning down something to “take the edge off” and surgery… I CAME OUT OF HYPNOSIS.
And that is when I experienced pain like I have not felt before in my life.

I understand why people (who have not practiced the use of natural epidurals) make comments like “You’ll be screaming for the epidural.” Because it was pretty overwhelming…

It was like something had switched to the off button inside of me. Since the decision for the c-section was made, I was thinking “No need to keep rallying anymore…” and my natural defenses for dealing with the surges were void.

Apparently it was another 45 minutes from the time the decision was made for the c-section until Holden officially joined us…

The O.R. (sans McDreamy, to say the least)
I was a patient…there was no way around it. I was wheeled in on my bed -- harsh bright fluorescent lights only served to magnify the stark white sterility of the room. I was thinking about the irony – more crying about the irony under the o2 mask with a giant lump in my throat. What a difference from my birthplan this experience was! I’d requested that the lights be dimmed on Holden’s entrance to the world… here, there would be no dimming. There was no background music. There was nothing about this experience that could be defined as “calming”… but Holden would be here soon.

The contractions were still coming (why did I come out of hypnosis!?!?!); and Danny had not been admitted into the room yet. I felt naked, cold and exposed; though a lot of that could’ve been that my hospital gown was open on its backside for the spinal. The Anesthesiologist asked me to curl up in a ball – cat like position) so he could administer the spinal. He told me to pull in tighter and at that moment a contraction came, and I can honestly say I’ve never been more miserable in my life.

Emotionally, I felt like I had nothing left to give. I was in this awful dream like state that felt more like a nightmare… everything was still hazy and I just kept wondering why I was so alone.

Why was it happening this way?
What was wrong with me?
And why wasn’t Danny here yet?

It must’ve just been a moment because suddenly the pain ceased and Danny was by my side, holding my hand. The tears kept streaming, but Holden would be here soon. While there was no pain, it was odd to feel pressure and sensation in my lower abdomen while they moved things around. I tried not to look, but glanced up and saw a reflection in the metal of the lights. It was pretty nasty.

And then, like a miracle… he was here, and every emotion I had been thinking was washed away as one thought over took me.

He’s here.

… and time stopped, and nothing else mattered, and my heart expanded throughout the eternities.

The nurse brought him around past the curtain, he looked like a beautiful mess…


...eyes bulging, crying from the cold of the room and the harsh transition from my womb to the world. But you don’t think about that as a mother. All you think is – perfection.

While they stitched me up, Danny went back to watch as they checked and cleaned Holden (again, much different than we had planned. I though Danny would end up cutting the cord, and Holden would be handed to me to lie skin-to-skin on my bare chest with a blanket covering him as they cleaned him. But not so.) As I mentioned, they were worried about Holden aspirating so all I got was a peak at my baby.




I can’t describe the intense sensations that were going through me…an almost preternatual desire to be near my child. It seemed like forever that Danny and Holden were gone.

I can’t remember the exact order of events, but eventually Holden was brought to me in my room. My in-laws and mom were there, and everyone was anxious to greet our new addition. But I was not in the mood for sharing. I took Holden into my arms and again, time stopped and it was just to two of us.

He was calm and almost looked inquisitive. He’d purse his bottom lip (a look that I would come to recognize more and more as we spent time together) and drift in and out of sleep. It had been a long 24 hours for both of us. And so mommy and baby shut the outside world out.

Apres L&D
Over the next few days, I would battle the emotional demons of having a cesarean. Continually asking the gods why, and feeling guilt over everything I had put Holden through. His glucose levels presented some challenges with a drop in body temperature (which they thought had to do with a calcified placenta that was not really working), and they had to give him formula from a bottle (which I still maintain was the start of our breastfeeding woes)… I kept thinking that I would’ve never waited so long if I had known he’d be in distress; and at the same time feeling like my body was broken because I never dilated and needed all of the medical interventions to get my baby here.

Everyone kept reminding me that he was here, and that’s all that mattered… and it’s true. But somehow, I couldn't separate the two issues in my mind. Holden was here – safe – and that was the ultimate objective… at the same time, I kept coming back to the guilt and shame of needing all of the interventions.
What would people say?
What would they think?
Am I less of a woman?

Coming from a religious background where it’s been drilled time, and time again that motherhood is basically the ultimate goal, and yet if I had been alive 100 years ago, Holden and I would not have made it… what does that say about me?

Over time, I would come to recognize and accept that it didn’t matter what the answer to these questions were. And for whatever reason (that I needed to learn I’m not in control, or so that Holden could have a perfectly round head, or something more) I was not to know…


Holden was here.
And everything was perfect and everything is perfect.


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